The Days Before the Diagnosis: Take 2

On Wednesday, April 11, our 17 month old woke up fussy and a bit warm. My husband held her and made his breakfast while I continued packing lunches for our other 3 kids. Harper started to gag so my husband rushed her to the sink right before she vomited up a bit of mucus. She was fine after that, and we didn't give it much thought. She continued to feel warm most of the day, but her temperature hovered around 99. I thought maybe she was cutting a new tooth, and settled on the couch with her for most of the morning. She napped, we drove to pick up her siblings and played outside for about an hour after school. She only played for a while and then spent time in my lap. She slept hard that night, and had soaked through her diaper, which hadn't happened in quite some time. She woke up a few times throughout the night and asked for a drink each time.

The next day was very similar, although her fever was hanging around 100.3 and she just wanted to sleep most of the day. When my husband came home for lunch, he was once again holding her in the kitchen when she projectile vomited all over the floor, cabinets, and herself and her father. She was sleepy and cranky when she wasn't being held. We weren't overly concerned, as she still seemed pretty normal, just tired and not feeling quite right. 

By the time my husband got home from work that evening, he noticed that her breathing sounded a bit strange. I hadn't noticed it too much because she hadn't been awake much all day, just napping and nursing and napping some more. She wasn't wheezing, I would describe it as grunting, almost as if she was trying to poop but couldn't. (We now know this breathing is called kussmaul breathing and it's classic with kids in DKA.)

That night was rough. Harper didn't sleep well, and she soaked through 2 diapers in the course of the night. Each time she woke up, she begged for "wawa" (water) and drank like a camel in the desert. We had never seen her do anything like it. My husband thought maybe her throat was sore. She had obviously been fighting a bug of some kind. Way, way, way in the back of my head, diabetes crossed my mind. But I didn't give much merit to it. She's still a baby! She's just got a stomach bug! Though the excess thirst and urination did make me wonder. 

On Friday, my husband drove our oldest to school and then stayed out at a coffee shop to work on a class he was teaching, while I stayed home with the younger 3. Harper's breathing continued to disturb me, so my husband and I started texting our doctor friends from church. One friend said to wait it out and monitor her breathing, while another said the breathing was concerning. I also tried to get her in to see our pediatrician but she had no availability. Based on what I was describing with her breathing, the nurse recommended we head to urgent care or the ER. My mom-sense was on edge and I was starting to think we should just take her to be seen. I convinced myself that Harper's feet were starting to look blue and worried that she wasn't getting enough oxygen. I held her and thought her lips looked blue as well so I called my husband to hurry home so we could take her in. 

I put her on my bed so I could change clothes and brush my teeth and as soon as I laid her down, she vomited. She hadn't eaten in 2 days, so I was taken aback, but more concerning was the mud-colored sludge that came out of her. I shot my husband a picture and he thought it looked like blood. By the time he got home, I was mildly panicking and he affirmed when he saw her that she looked pale and blue-lipped. We headed out, not sure if we were headed to urgent care or the ER, when he made the executive decision to go to the ER. 

She must have looked worse than we thought, because despite the busy waiting room, a doctor immediately came out and listened to her breathing while I held her. He thought one side sounded a bit sluggish and thought a chest x-ray might be in order to rule out pneumonia. After a short wait, we headed back to get vitals and talk about what had been going on. We showed the doctor a picture of the vomit from the bed and he was obviously concerned. They led us to a triage room and started the long, arduous, torturous process of trying to find a vein on a small, dehydrated toddler so they could run bloodwork...